The candy display near the supermarket checkout line may be contributing to the U.S. overweight and obesity epidemic.

An editorial published on Oct. 11, 2012 in The New England Journal of Medicine suggests that advertising and the location of certain food items may be leading to impromptu purchases of unhealthy foods. For example, candy near the cash register is actually a strategy known as "impulse marketing," which encourages emotion-propelled buying. Items placed in easy to see end-of-aisle locations make up for 30 percent of all supermarket sales, the researchers note.

"The reality is that food choices are often automatic and made without full conscious awareness," the authors wrote. "In many cases, they may even be the opposite of what the person deciding would consciously prefer. What and how much people eat are highly influenced by contextual factors that they may not recognize and therefore cannot easily resist."

About 33.3 percent of adults 20 years and older are overweight and an additional 35.9 percent are obese, according to the Centers of Disease Control and Prevention. An adult who has a BMI of 25 to 29.9 is considered overweight, while an adult who has a BMI of 30 or higher is considered obese. Further, men who have a waist circumference of over 40 inches and women who have a waist circumference of over 35 inches are at a higher risk for type 2 diabetes, hypertension and cardiovascular disease.

The researchers argue as people try to make healthy food choices, they get inundated with unhealthy options, especially when they become distracted, under stress, tired or have made so many other decisions they can't possibly make another good one.

"Once cognitive capacity is depleted, automatic processing that relies on heuristics and other shortcuts dominates, and under these circumstances people are more likely to choose foods high in sugar and fat," the researchers wrote.

They suggest that people should consider product placement a "hidden risk factor" and more should be done to help people make good food choices. Just like people have mandatory rail guards and window guards to prevent them from falling, people should have food "guards" to help stop them from picking up that pint of ice cream or bag of chips, the researchers argue.

"We need to test new approaches to risk reduction that do not place additional cognitive demands on the population, such as limiting the types of foods that can be displayed in prominent end-of-aisle locations and restricting foods associated with chronic diseases to locations that require a deliberate search to find," the authors wrote. "Harnessing marketing research to control obesity could help millions of people who desperately want to reduce their risks of chronic diseases."

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